Case report of a solitary liver tumour in a young adult following childhood ewing sarcoma

Abstract

<h3>Aim</h3> To discuss a case of a solitary liver tumour occurring in an adult female with a past history of childhood Ewing sarcoma (treated with surgery and chemotherapy). <h3>Methods</h3> The clinical history and investigations were discussed. The macroscopic and microscopic findings were then presented, including results of special stains and immunohis-tochemistry. A literature review was also performed. <h3>Results</h3> While focal nodular hyperplasia was considered a likely diagnosis, and a recurrent malignant tumour needed to be excluded, the lesion was found to be a hepatocellular adenoma. <h3>Discussion</h3> Focal nodular hyperplasia (FNH) has been reported as a late complication in patients who received chemotherapy for malignancy.¹ One possible theory is that chemotherapy may injure the vascular endothelium and cause localised circulatory disturbances, with progression to FNH. Given the past history of chemotherapy and lack of exposure to the oral contraceptive pill, the final diagnosis of a hepatocellular adenoma (HCA) was unexpected. While 85% of patients with HCA are women who have taken the oral contraceptive pill for more than two years, in 15% of cases there is no history of taking the pill.² This case is therefore considered an unusual case of coincidental hepatocellular adenoma following chemotherapy for Ewing sarcoma.